Inadequate sleep is a major health problem of childhood that often fails to receive attention until significant neurobehavioral and other health problems are noted. Although adequate sleep is essential for normal growth and brain development, studies show that children from minority and economically disadvantaged families are more likely to experience shorter sleep times and more sleep fragmentation compared to their Caucasian and economically advantaged counterparts. As a result, they are disproportionately affected by the adverse health and quality of life consequences of poor sleep. There are currently no intervention studies to our knowledge aimed at addressing sleep disparities by improving sleep duration and sleep hygiene in early school-aged children from minority populations. This study seeks to close the 'sleep gap' that exists between the sleep duration of minority school-aged children and that of their non-minority peers. An interdisciplinary team of researchers and clinicians from Columbia University's Pediatric Lung and Sleep Disorders Center, School of Public Health, Psychiatry Department, and two outpatient clinic systems affiliated with Columbia will collaborate to reduce sleep disparities by improving sleep duration in a group of 5-6 year old minority children. The primary goal of this study is to evaluate the efficacy of a tailored, interactive, educational and behavioral intervention that utilizes trained sleep counselors to assist parents in improving their children's sleep hygiene and reducing risk factors for poor sleep, thereby increasing sleep duration over a 12-month period in a randomized controlled trial of children identified with sleep problems (Aim 1). We will screen 375 parents of 5-6 year old children from 5 primary care clinics to identify children with and without sleep problems and enroll 90 of the 375 children screened who have sleep problems in a randomized controlled trial of an in-home sleep intervention. Using an initial home assessment, baseline actigraphy (motion monitor) data, sleep logs recorded by parents, and information regarding risk factors for poor sleep collected from each family during screening, we will work with parents of children randomized to the intervention group to develop a personalized sleep plan for their children. We will evaluate the impact of the intervention on: a) nightly sleep duration; b) neurocognitive function; and c) behavioral disorders. PUBLIC HEALTH RELEVANCE: This study addresses the important problem of shortened sleep duration among early school-aged minority children, a group that has received little attention in sleep studies. Insufficient and disrupted sleep in school- aged children has been correlated with learning, behavioral, and other health problems that may last throughout childhood. Studies suggest that while sleep problems in infancy are often transient, some sleep problems present in early school-aged children are likely to persist therefore, by intervening at ages 5-6 years, we may be able to reduce sleep problems in these children as they get older.